“This is another indication of the need for improving the care of patients in the community.

“We cannot fix hospital presentations by looking at hospitals alone – years of underfunding of general practice, followed by rebate freezes have impacted on access to quality care in the community,” Dr Lim said.

“All told, just under100,000 people or about a seventh of the overall number of people presenting at EDs over Q3 2018 were categorised as triage 1 or 2 – those most urgently in need of care.

“This continues a trend that’s been observed ever since the Bureau of Health Information started publishing its records – people presenting at NSW hospitals are getting sicker and sicker.

“It’s also worth noting that many of the bigger hospitals did not see a reduction in patient numbers like the state average would suggest.

“The massive demand for emergency care we saw in Q3 2017barely changed at hospitals like Westmead, Nepean, Royal North Shore, and many others.

“Our busiest hospitals remain under extraordinary pressure due to both the sheer number of patients and their increasingly complex needs,”Dr Lim said.